Microcomputer-based system for the study of the respiratory system in newborns

A useful understanding of the respiratory system of premature infants and the factors contributing to different physiological mechanisms and diseases requires extensive clinical research. This project is the result of a need for a fast and reliable system to process the information obtained from biological sources and to obtain results from which different hypothesis can be tested. This document presents a description of one such system and its different subsystems. It describes the biosignals of interest as well as the stages they have to go through in order to obtain an accurate and valid analysis. The system is hardware and software oriented. The system hardware is subdivided into instrumentation system, which is used to pick up and condition the signals, and a data acquisition, monitoring and storage system, where the signals are digitized and stored for later processing. The system software, which is the basic and principal component of the project, participates in the hardware control for the data acquisition, storage and monitoring, as well as the posterior stages of signal processing and analysis, which constitute the key of the system. The biosignals mentioned above can be classified as muscular or EMG, respiratory, chest wall motion, and cardiac signals. The muscular signals are obtained from measuring the electrical activity of the muscles participating in the process of ventilation and the respiratory signals reflect mechanical characteristics of the lungs and airway passages, the chest wall motion signals give a measurement to evaluate the chest wall stability, and the cardiac signals which are measurements of the electrical activity irradiated by the cardiac muscle. These biosignals require extensive processing, especially the EMG signals, before analysis. The signal processing stage uses digital signal processing techniques which were developed or adapted for this purpose. The signal analysis stage is based on research protocols and physical relations to evaluate different respiratory parameters. Special data and file handling software was developed and applied as well as graphics software, to accomplish the stages mentioned above

ICA-Puracé, una nueva variedad de papa con altos rendimientos

Se describen las caracteristicas más sobresalientes de la variedad de papa ICA-Puracé a saber: resistencia a la gota, rendimiento, periodo vegetativo, calidad, almacenamiento, caracteristicas del tuberculo (tamaño, forma, ojos, piel y carne), características de la planta y cultivo. Así mismo, se mencionan las características de los progenitores que la originaron: a saber: los clones CCC 746 (femenino) y CCC 105 (masculino)Papa-Solanum tuberosu

Randomized crossover comparison of proportional assist ventilation and patient-triggered ventilation in extremely low birth weight infants with evolving chronic lung disease

Background: Refinement of ventilatory techniques remains a challenge given the persistence of chronic lung disease of preterm infants. Objective: To test the hypothesis that proportional assist ventilation ( PAV) will allow to lower the ventilator pressure at equivalent fractions of inspiratory oxygen (FiO(2)) and arterial hemoglobin oxygen saturation in ventilator-dependent extremely low birth weight infants in comparison with standard patient-triggered ventilation ( PTV). Methods: Design: Randomized crossover design. Setting: Two level-3 university perinatal centers. Patients: 22 infants ( mean (SD): birth weight, 705 g ( 215); gestational age, 25.6 weeks ( 2.0); age at study, 22.9 days ( 15.6)). Interventions: One 4- hour period of PAV was applied on each of 2 consecutive days and compared with epochs of standard PTV. Results: Mean airway pressure was 5.64 ( SD, 0.81) cm H2O during PAV and 6.59 ( SD, 1.26) cm H2O during PTV ( p < 0.0001), the mean peak inspiratory pressure was 10.3 ( SD, 2.48) cm H2O and 15.1 ( SD, 3.64) cm H2O ( p < 0.001), respectively. The FiO(2) ( 0.34 (0.13) vs. 0.34 ( 0.14)) and pulse oximetry readings were not significantly different. The incidence of arterial oxygen desaturations was not different ( 3.48 ( 3.2) vs. 3.34 ( 3.0) episodes/ h) but desaturations lasted longer during PAV ( 2.60 ( 2.8) vs. 1.85 ( 2.2) min of desaturation/ h, p = 0.049). PaCO2 measured transcutaneously in a subgroup of 12 infants was similar. One infant met prespecified PAV failure criteria. No adverse events occurred during the 164 cumulative hours of PAV application. Conclusions: PAV safely maintains gas exchange at lower mean airway pressures compared with PTV without adverse effects in this population. Backup conventional ventilation breaths must be provided to prevent apnea-related desaturations. Copyright (c) 2007 S. Karger AG, Base

El cultivo de la papa.

La papa crece bien entre los 6 y 17 grados centígrados, en tierras fértiles, suelos francos o franco arcillosos, con pH de 5 a 6. Se recomiendan las variedades mejoradas ICA-Puracé, capiro, monserrate, parda pastusa, presentándose su rendimiento en to/ha, resistencia a gota, calidad culinaria y para almacenamiento. Se destaca la importancia de que el suelo quede bien mullido, y sembrar 16 cargas/ha (2 ton) de semilla de segunda o pareja a un m entre surcos y 30 a 40 cm,entre matas. Se indica que en Cundinamarca, Boyacpa y Nariño, la siembra de año grande es del 15 de Enero hasta mediados de Febrero y mitaca del 15 de Julio al 15 de Agosto. El uso de abonos debe hacerse según los análisis de suelos, la fórmula general usada es 10-30-10 una ton/ha. Para controlar gota se recomienda manzate, dithane M-22, dithane M-45, 2 kg/ha. Si no se aplica matamalezas, el deshierbe debe efectuarse con el suelo húmedo. La papa madura entre 5 y 6 meses. Se deben usar inhibidores de brotamiento como Cloro IPC para almacenar papa para consumo en lugares oscuros y fríos. En papa para semilla no deben utilizarse inhibidores de brotamiento. Se recomienda el control cultural y control químico para plagas como chiza, trozadores, tostón, pulguilla, áfidos o poulgones, lorito verde y cigarritasPapa-Solanum tuberosu

Recomendaciones generales sobre el cultivo de la papa en el Departamento de Nariño.

Con base en estudios experimentales llevados a cabo durante años, se presentan algunas recomendaciones sobre el cultivo de la papa en esta región del país. Se tratan aspectos relacionados con: épocas de siembra, preparación del terreno, distancias de siembra, tamaño de la semilla, sanidad y pureza, fertilización, control de plagas del suelo y de las malezas, control de la gota, control de plagas del follaje, aporque, cosecha, clasificación, almacenamiento. Finalmente, se describen las características más sobresalientes de la variedad Diacol Capiro, entregada por el ICA en 1965Papa-Solanum tuberosu

Latin American registry of renal involvement in COVID-19 disease. The relevance of assessing proteinuria throughout the clinical course

The Latin American Society of Nephrology and Hypertension conducted a prospective cohort, multinational registry of Latin American patients with kidney impairment associated to COVID-19 infection with the objective to describe the characteristics of acute kidney disease under these circumstances. The study was carried out through open invitation in order to describe the characteristics of the disease in the region. Eight-hundred and seventy patients from 12 countries were included. Median age was 63 years (54–74), most of patients were male (68.4%) and with diverse comorbidities (87.2%). Acute kidney injury (AKI) was hospital-acquired in 64.7% and non-oliguric in 59.9%. Multiorgan dysfunction syndrome (MODS) due to COVID-19 and volume depletion were the main factors contributing to AKI (59.2% and 35.7% respectively). Kidney replacement therapy was started in 46.2%. Non-recovery of renal function was observed in 65.3%. 71.5% of patients were admitted to ICU and 72.2% underwent mechanical ventilation. Proteinuria at admission was present in 62.4% of patients and proteinuria during hospital-stay occurred in 37.5%. Those patients with proteinuria at admission had higher burden of comorbidities, higher baseline sCr, and MODS was severe. On the other hand, patients with de novo proteinuria had lower incidence of comorbidities and near normal sCr at admission, but showed adverse course of disease. COVID-19 MODS was the main cause of AKI in both groups. All-cause mortality of the general population was 57.4%, and it was associated to age, sepsis as cause of AKI, severity of condition at admission, oliguria, mechanical ventilation, non-recovery of renal function, in-hospital complications and hospital stay. In conclusion, our study contributes to a better knowledge of this condition and highlights the relevance of the detection of proteinuria throughout the clinical course

Closing the loop of mechanical respiratory support for preterm infants

Premature infants require mechanical respiratory support to maintain adequate gas exchange, which consists of positive pressure ventilation and supplemental oxygen. However, the needed respiratory support often contributes to lung injury and other morbidity. Clinicians reduce the support to avert lung injury due to excessive and/or repeated lung inflation and oxygen toxicity. However, weaning is often delayed by fluctuations in ventilation and oxygenation due to instability of the respiratory system and spontaneous respiratory drive.This work included the development of a system for closed loop targeted minute ventilation (V\u27E) continuously that adjusts ventilator frequency to maintain a desired ventilation level, a system for closed loop targeted tidal volume (VT) that adjusts the ventilator pressure to generate a desired tidal volume, and a third controller that results from the combined application of these controllers in parallel.This work also involved development of a system for oxygenation targeted closed loop control of the fraction of inspired oxygen (FiO2). This system maintains oxygenation within an adequate range during fluctuations in oxygenation with the least FiO2.A clinical study showed the efficacy of closed loop targeted V \u27E in reducing the ventilatory support, without adverse effects on gas exchange in a group of premature infants compared to conventional mechanical ventilation.In an animal study, closed loop targeted V\u27 E and closed loop targeted VT were shown to be effective in maintaining ventilation and oxygenation in a rabbit model of apnea, reduced lung volume and respiratory system compliance. In this study, the combined controller was more effective than the individual components.A clinical study demonstrated the efficacy of the system for oxygenation targeted closed loop FiO2 control in maintaining oxygenation in a group of ventilated premature infants who presented with frequent and acute episodes of hypoxemia.In summary, this work documented the feasibility of closed loop control of mechanical respiratory support for premature infants. These techniques were effective in reducing the support and in maintaining ventilation and oxygenation by adapting to the changing needs of premature infants. This form of support may reduce the risk of lung injury and oxygen toxicity

Automated regulation of inspired oxygen in preterm infants: oxygenation stability and clinician workload

Premature infants are at an increased risk of ophthalmic, neurologic, and respiratory sequelae related to inadequate maintenance of oxygenation and exposure to increased levels of inspired oxygen. Management of inspired oxygen is complicated in this population by an increased variability in oxygenation. Automated regulation of the fraction of inspired oxygen is a technology that has a potential of improving such outcomes as well as impacting personnel workload. This is a review of current experimental evidence on the effectiveness of automated regulation of inspired oxygen and its effects on oxygenation variability and personnel workload during the care of premature infants